| NPI | 1942680657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-45054) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301107959) |
| 207R00000X Internal Medicine (Licence: IA MD-45054) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2018-04-24 |